Organization
LE BONFIRE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANA RICHARDSON (DIRECTOR)
(321) 674-9066
Entity
Organization
Contact information
Practice address
152 BONFIRE AVE NE, PALM BAY, FL 32907-3163
(321) 674-9066
Mailing address
152 BONFIRE AVE NE, PALM BAY, FL 32907-3163
(321) 674-9066
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12307
FL
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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